Deciding is about choosing what improvements to make and how to make them. Its success depends on an understanding of the patient journey and the insights about service improvement this offers.

Health service decisions are often made primarily based on the needs and interests of the service. This does not exclude patient needs and experiences, but invariably demotes them to secondary importance. Involving patients in decision-making helps ensure balanced and effective improvements are made to a service. It also helps build service improvements that offer mutual gains for both patients and the service.